Interpleural anesthesia is a technique that has been developed in an attempt to “simplify” body wall and visceral anesthesia after upper abdominal or thoracic surgery. Although considerable research has been carried out, accurate stratification of the risks and benefits of interpleural anesthesia remains elusive.

Patient Selection.

Patients undergoing upper abdominal or flank surgery or those recovering from fractured ribs have been the patients most frequently selected for interpleural anesthesia. Again, appropriate selection criteria for these patients remain ill-defined.

Pharmacologic Choice.

Most commonly, 20 to 30 mL of local anesthetic solution is injected via an interpleural needle or catheter. The most common local anesthetic concentrations used have been 0.25% to 0.5% bupivacaine and 0.2% to 0.5% ropivacaine.